Conclusion
It appears from the fragmentary epidemiological data presented in this article that snake-bites remain a public health problem in most countries, even if it is dificult to be precise about the actual numbers involved. The global figures given by Swaroop & Grab (102) over 40 years ago were greatly underestimated. The true incidence of and mortality from snake envenomations could exceed 5 million per year, with an associated mortality level of 125000 persons per year. About 2.5 million people are envenomed each year, half of whom request medical care, and probably more than 100000 individuals suffer from severe sequelae (Table5).
The global disparity in the epidemiological data for snake-bites reflects the variation of health reporting accuracy and the great diversity of ecological and economic conditions through out the world (Fig.1). Agricultural activities are associated with most of the bites. The snake species involved can be very dangerous because of the toxicity of their venom or abundance in are as close to human settlements. Finally, health facilities and availability of antivenin have to be considered in implementing the treatment of envenomations. Clearly
in developing countries, where snake-bites are the most prevalent, none of the requires conditions for their correct managemeant is fulfiled. In most developing countries, lack of medical attention, specially antivenin therapy, leads to high mortality levels. Considerable effort will be needed to develop studies on snake-bite epidemiology and improve the distribution and use of antivenin.